Provider Demographics
NPI:1366767485
Name:CHANSON, CARRIE (MD, DRPH, MPM)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:
Last Name:CHANSON
Suffix:
Gender:F
Credentials:MD, DRPH, MPM
Other - Prefix:
Other - First Name:MING YU
Other - Middle Name:
Other - Last Name:CHENG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:328 COMMERCIAL RD STE 101
Mailing Address - Street 2:LOMA LINDA OCCUPATIONAL MEDICINE CLINIC
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3766
Mailing Address - Country:US
Mailing Address - Phone:909-558-6662
Mailing Address - Fax:
Practice Address - Street 1:328 COMMERCIAL RD STE 101
Practice Address - Street 2:LOMA LINDA OCCUPATIONAL MEDICINE CLINIC
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3766
Practice Address - Country:US
Practice Address - Phone:909-558-6662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-31
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1220432083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine